Prevalence and Factors Associated with Hypertension among Community-Dwelling Adolescents in a Rural Area of Haryana, India, Using AAP 2017 and NHBPEP Criteria

Objective To estimate the prevalence and determinants of hypertension among adolescents in a rural area in North India. Methods This was a cross-sectional study conducted among community-dwelling adolescents (10-19 y) and defined blood pressure as per the National High Blood Pressure Education Program (NHBPEP) and American Academy of Pediatrics (AAP) 2017 criteria. A pretested, semistructured questionnaire was used to elicit sociodemographic details and risk factors of hypertension. Association of factors with hypertension, z scores of systolic blood pressure (SBP) and diastolic blood pressure (DBP) were assessed by logistic and linear regression. In multivariable regression model, for both logistic and linear regression, variables with p value < 0.2 were included, excluding collinear variables. Results Eight hundred sixty-four adolescents participated with mean (SD) age, BMI of 14.0 +/- 2.6 y, 18.3 +/- 3.5 kg/m(2). Hypertension prevalence was 22.5% (95% CI: 19.7, 25.5) as per AAP and 15.2% (95% CI: 12.9, 17.8) as per NHBPEP criteria. Being hypertensive as per the AAP was associated with family history of noncommunicable disease (NCD) (adjusted odds ratio, AOR 1.80, 95% CI: 1.11, 2.86) and BMI (AOR = 1.09, 95% CI: 1.04, 1.14), and as per the NHBPEP, was only associated with BMI (AOR = 1.11, 95% CI: 1.05, 1.17). SBP z score was significantly associated with male sex (adjusted beta coefficient AC = 0.79, 95% CI: 0.69, 0.90), and weight z scores (AC = 2.00, 95% CI: 1.22, 3.28); DBP z score was significantly associated with z scores of height (AC = 0.70, 95% CI: 0.51, 0.96) and waist (AC = 1.15, 95% CI: 1.02, 1.30). Conclusion The prevalence of hypertension among adolescents was high and was associated with BMI and family history of NCD.